Closed unit - HELP!!!!

timonrn · Nov 13, 2000

Our unit is headed that way, too--the sooner the better. We just started a Maternal-Child float pool with six 12-hour nurses and their job is to staff just our Womens & Childrens unit (OB/PEDS/NSY/GYN/NICU/LDR) and it works out well-we are looking into expanding to 12 nurses. Then we can close our unit. While our OB/GYN/NSY staffing is currentely done by central staffing, our NICU does their own for many years and they never have staffing issues as bad as us--and the holiday coverage isn't the nightmare we on OB has--so I can't wait. I'd like ideas, too---

bbnurse · Nov 23, 2000

We are trialling unit based staffing (closed unit). We basically cover LD, PP, Nursery and peds with cross trained staff. We have 4 PRN type persons who work 2-4 shifts per month and had two pool persons (who have since left or joined our PRN staff). Staff negotiate coverage for short shifts. We are either available if the need for staff occurs d/t high census or illnesses, or ON Call for LD. The difference is immediate availability for ON CALL and call back pay. We can only have 2 person/week off on PTO unless every shift for the week has someone covering for the influx of census or illness.

We can use agency if a "TRUE" emergency occurs but so far have not needed to do so. We take turns being flexed when census is low. We have learned to be flexible about our schedules if income needs to be steady. So far, in 5 months, we have cut our overtime and use of PTO. Our staffing is based on AWHONN's guidelines and the flexibility has to be built in. We have the Team Leader or the Director as the extra prs. of hands in a crunch. Their willingness to help out makes all of us more willing to come in when needed. No more floating. No more frustration. True collaboration is possible. So far we are happy with it. Our "rules" were asked for by the ICU staff and we were happy that our "trial" has been well accepted by all. Good luck on trying it. Think out all the contingencies and it will work. Our team helped design the rules. We knew the issues and that made it work for us.